Carissa Shantell Carson

Primary specialty

Birthing Clinic/CenterTaxonomy code 261QB0400X

Practice address

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Phone

(314) 251-6000

NPI assigned

Nov 2, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1578075313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3632 WATSON RD APT A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631091232",
            "telephone_number": "314-374-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3632 Watson Rd Apt A",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631091232",
            "country_code": "US",
            "telephone_number": "314-374-2290",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6420 Clayton Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond Heights",
            "state": "MO",
            "postal_code": "631171811",
            "country_code": "US",
            "telephone_number": "314-768-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3015 N Ballas Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631312329",
            "country_code": "US",
            "telephone_number": "314-837-7470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARSON",
        "first_name": "CARISSA",
        "middle_name": "SHANTELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QB0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Birthing",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175M00000X",
            "taxonomy_group": "",
            "desc": "Midwife, Lay",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Carroll
• Jill Carron, MS
• Maria Renee Carron, MT-BC
• Sue L Carron, PT
• Terri L Carron, MD
• Christine Carson, D.C.
• Lisa G Carson, OT
• Madeleine Carson, MSW, LCSW
• Nicholas Richard Carson, B.S
• Zachary Pierce Carson

• Birthing Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Birthing Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.